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Being away from home and your familiar medical team can make receiving a diabetes diagnosis more difficult, experts say.

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It all started with an itch down there. At first, I thought my newfound discomfort was brought on by a new hygiene routine. “It must be that new body wash I bought,” I said to myself. I always heard rumors that cleansing yourself down there with fruity, fragranced soaps could wreak havoc on the pH balance in your vagina, and now it seems I was paying the price. I hurried myself to the bathroom to wash off with something less pungent, and relief came, albeit temporarily. But the tingly feeling never subsided and it returned with a vengeance later the next evening. In the days that followed, the feeling intensified and eventually progressed to a full-blown rash.

I began to panic, concerned that I had acquired a sexually transmitted infection (STI). Going into fix-it mode, I dialed up the local hospital in the sleepy town of Chilgok, South Korea, where I was living and working at the time as an English teacher. Mustering up all the broken Korean I could, I tried to explain the feeling I was having to the woman on the other end of the line. Days later, I was in stirrups as a doctor stared intently at my nether-regions. “Is yeast infection,” she informed me. “I put medicine in, all better.”

Continued Struggles With Frequent Urination and Discomfort

But it wasn’t all better. The medicine did little to nothing, and for the next few months, I continued to be afflicted by what I’ve since called the Great Yeast Infection of 2014. Oh, the yeast infection was bad — eventually spreading down my thighs, forming clusters underneath my armpits and breasts, making me feel as if I were no longer in control of my own body.

To top things off, I couldn’t stop peeing. My sleep was routinely interrupted by upwards of six bathroom visits a night. Although my doctor visits became more frequent, the course of treatment remained the same as the fire in my crotch intensified. I often found solace in bulgogi (grilled marinated beef); white rice; and soda pop.

Seeking a Second Opinion in Search of a Diagnosis

Fast-forward to an impromptu getaway that fall in New Orleans, when I hightailed it to a free clinic and a blood test that began to hint at the culprit, which had lain in plain sight in my bloodstream: excess sugar. Six months later, I received the official diagnosis: I had type 2 diabetes. It turns out that the disease was the source of my discomfort all along.

Why Early Signs of Diabetes Are Often Missed

As painful and emotionally taxing as this experience was, it turns out my story isn’t uncommon. Although type 2 diabetes has become a global epidemic, with the World Health Organization (WHO) estimating that there are currently 422 million adults worldwide with type 2 diabetes, often, doctors miss the signs of the disease.

Sometimes it’s because people with diabetes are asymptomatic altogether, says William Hsu, MD, the vice president of international programs and innovation at the Joslin Diabetes Center in Boston. In those people who are symptomatic, like me, signs like frequent urination, excessive thirst, and fatigue occur. People with diabetes who are asymptomatic may remain so for anywhere from a few months to a few years, Dr. Hsu adds.

According to the latest data from the Centers for Disease Control and Prevention (CDC), an alarming number of people don’t realize they have the disease. While 30.3 million American adults have diabetes, nearly one in four adults with diabetes, or 7.2 million Americans, don’t know they have the disease. And 90 percent of people with prediabetes — a precursor to diabetes that leads to diabetes in five years if untreated — are unaware that they have the condition, the CDC notes. Overall, 84.1 million American adults have prediabetes.

Why Living Abroad Can Further Complicate Diagnosis of Diabetes

While the tests for diabetes are largely the same in most countries, if you're living abroad, particularly when you don’t have an established medical team, you may be misdiagnosed. “People living in unfamiliar settings while abroad usually don’t have access to a doctor they see on a regular basis. So a diagnosis can be missed without regularly scheduled checkups with a healthcare provider,” Hsu explains.

And unfortunately, a missed diabetes diagnosis can increase the risk for certain complications, such as neuropathy (nerve damage), which can affect the feet and eyes; skin discoloration; heart disease; kidney disease; amputations; and death.

But if you are living abroad, and especially if your genetics leave you at a greater risk of the disease, you can still take proactive steps toward making sure a potential case of diabetes is diagnosed swiftly.

Here's what to do:

Know the signs. The American Diabetes Association recommends screening for people who are over age 45, people who are overweight or live a sedentary lifestyle, and those people whose ethnicity may leave them at a greater risk of the disease. For example, people of African-American, Hispanic, Native-American, Asian, and Pacific Islander descent are statistically at a greater risk of developing diabetes.

Seek out a diabetes specialist if possible. If you suspect that you might have diabetes but don’t know where to find answers, Hsu suggests seeking referrals from trusted resources for a reputable doctor or hospital. Consider seeking an opinion from an endocrinologist, a certified diabetes educator, or a primary care physician — all people on a typical diabetes medical team who can help shed light on your symptoms and determine whether you may have diabetes.

Don’t be afraid to ask questionsand speak up. In my case, part of the reason my diabetes diagnosis didn’t come sooner was because I didn’t force my doctor’s hand — I assumed she knew best. I should have spoken up and expressed the concern I genuinely felt — I knew something was wrong, and I should have said so.

Know that differences in healthcare systems can help. Diabetes is a challenging epidemic that plagues not just Western countries but nations all across the globe. Hsu points out that in some non–first world nations, for instance, an underdeveloped healthcare infrastructure can have a significant impact on patients’ medical care, as well as doctor’s knowledge. Therefore, it might not always be best to just rely on the doctor’s understanding of any one thing. If you believe you are at risk, ask directly for diabetes testing, which can involve a fasting blood glucose test or an A1C, a reading of your average blood sugar levels over the past two to three months.

Why Advocating for Your Health Is Worth It

A type 2 diabetes diagnosis can be confusing and scary, but there is nothing shameful about advocating for your health if you believe you may be at risk of the disease or if you are exhibiting symptoms. Know also that with proper diet and exercise, the disease can be controlled or in some cases reversed. As it turns out, finding out I had diabetes was the end of my life as I once knew it: My diagnosis was the end of living an unhealthy, sedentary lifestyle. On the flip side, it was the beginning of me taking my life and personal wellness into my own hands. And for that I am so thankful.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health. See More

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